THREAD:. I'm bringing the sexy back into drains! @SIRRFS @SIR_ECS @SIRspecialists . Proud to present #BigPig a drainage solution so darn simple, all of #SIR23PHX will wonder why they've mucked around with the same boring catheters and dysfunctional connecting systems for decades.

RT @iRadBIR_Chennai: #Hemoptysis in a Cyanotic #CHD. #MAPCA #Embolization - Don't go too aggressive!. #iRad #MedTwitter.@ISVIRIndia @Murthy….

RT @EmiBarnard: There are 3 main pathways to becoming an interventional radiologist! . 🔘Integrated interventional radiology.🔘Independent in….

Sometimes you need a little #neuroIR in your life! See the case below posted by Dr. Ryan Morton:. #MIIPs #TwittiR #irad #withoutascalpel #medtwitter.#MedEd @SIRspecialists @SIRRFS @SAAngioClub .

RT @StationCDRKelly: Tell me more Dr Science.

RT @IRKhalsa: Asked ChatGPT to help me explain IR to my kids and here is what it came up with. Most definitely using it. Next up, dad jokes….

A total of 5 days went by from the original CT and the only doctor that could put the puzzle 🧩 pieces together was an IR consulted for a simple drain (I was consulted 2 days after the CT). I didn’t even do a procedure. I called the CMO. Patient went to surgery.

MRCP confirmed many choledocholiths in CBD. ERCP confirmed as well as reported removal. Also…GB leak/rupture. Only the surgical NP ever evaluated the patient. They copied and forwarded the Hospitalist note and all it said was “IR consulted for drain”. I was consulted again! 😤.

2 days went by. Surgeon balked. ERCP was done with cholangiography seen here:

I called the Hospitalist that consulted me and said I was highly concerned for GB rupture in the setting of likely CBD obstruction from choledocholithiasis. Immediate surgical consult! Could consider MRCP while we waited for the consult to get GI involved as well. See MRCP:

The axial and coronal CTs show the “collections” in question. Weird pattern. Why? What’s with the left liver? Tons of tiny hepatic abscess or bilomas? What’s with the GB? Decompressed with tons of stones and air! Is there a GB wall defect? Look at the CBD it’s 16mm! 👀

The power of an #irad IMO is the #Radiologist portion of our training. I was consulted for “hepatic abscess drain”. Some rad read the CT shown below only as collections and cholelithiasis. Question everything @SIRRFS @SIR_ECS as there are reason for “the collections”! See thread:

RT @LessneVIR: When stuck in portal with no way out, let's not forget our friend the Jr Sos #SecretSosFlip. #IRad . @SIRspecialists https:/….

🎯 🥷 . When the patient absolutely needs a biopsy and is high risk of bleeding…pick the path of least resistance (i.e., fat is your friend). 🎯 🥷 #irninja #MedEd #irad @SIRspecialists @SIRRFS @SIR_ECS @bayouteazy @LacayoMD

RT @_backtableINN: The wait is over! Your guesses and suggestions were all amazing. Our surprise guest is none other than @DGlaucomflecken!….

RT @_backtable: Coming APRIL 5 to a streaming platform near you…. @DGlaucomflecken @AdityaBagrodia @_backtableUro @_backtableobgyn @_backta….

Keeping the momentum…@bayouteazy got me all excited again to be using ablation dosimetry over here! LR-TR Viable in this large seg 3 HCC, particularly the more eccentric nodule adjacent to the falciform ligament seen in the CBCT during mapping. @SIRRFS @SIRspecialists #MedEd

Nobody tweets #drains but all #irad should be #assassins with their image guidance. I just really liked this left psoas abscess placement and decided to share 😊 #irads #MedEd @SIRRFS

RT @katecarrato: So much fun at #SIR23PHX hanging with the @Georgetown_IR fam, catching up with old friends, meeting new colleagues and lea….

So freakin proud of @bayouteazy aka Dr. Tyler Sandow from @OchsnerHealth @bsc_io presenting dose optimization for Y-90: A Sponge Can Only Hold So Much Water!